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首页> 外文期刊>Journal of shoulder and elbow surgery >Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation?
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Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation?

机译：巨大肩袖撕裂的背阔肌腱转移术后是否仍保持活动状态并恢复主动的外部旋转？

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Hypothesis: The purpose of this study is to evaluate the muscle activity with surface electromyography (EMG) and the clinical outcome of the latissimus dorsi transfer. It remains unclear whether the clinical results of the latissimus dorsi transfer for massive posterosuperior rotator cuff tears are achieved either by active muscle contractions or by a passive tenodesis effect of the transfer. Methods: Eight patients were evaluated preoperatively and at 1year (SD, 0.1) after the latissimus dorsi transfer. Clinical evaluation of outcomes included active range of motion, Constant score, and visual analog scale (VAS) for pain and activities of daily living (ADL). Muscle activity was recorded with EMG during directional isometric abduction and adduction tasks. Results: The external rotation in adduction improved from 23° to 51° (P= .03). The external rotation in abduction improved from 10° to 70° (P= .02). The mean Constant score improved from 39 to 62 postoperatively (P= .01). The VAS for pain at rest improved from 3.3 preoperatively to 0.1 (P= .02). The VAS for ADL improved from 4.9 to 2.3 (P= .05). The transferred latissimus dorsi remained active in all cases, as reflected by increased latissimus dorsi EMG activity during abduction tasks. In addition, the latissimus dorsi EMG activity shifted from preoperative antagonistic co-activation in adduction to synergistic activation in abduction. Conclusion: The latissimus dorsi has synergistic muscle activity after transfer. Apart from a tenodesis effect, directional muscle activity seems relevant for improved clinical outcome and pain relief. A specific gain was observed for external rotation in elevated arm positions, a motion essential for ADL tasks.
机译：假设：这项研究的目的是评估表面肌电图（EMG）的肌肉活动以及背阔肌转移的临床结局。目前尚不清楚通过活动性肌肉收缩或被动性肌腱定植效应，可实现背阔肌背阔肌移植治疗巨大的上后肩袖撕裂的临床结果。方法：对8例患者进行术前评估，并在背阔肌转移术后1年（SD，0.1）进行评估。结果的临床评估包括活动范围，恒定评分和视觉模拟量表（VAS）的疼痛和日常生活活动（ADL）。在定向等距外展和内收任务期间，肌电图记录了肌肉活动。结果：内收的外旋从23°改善到51°（P = .03）。外展时的外旋从10°提高到70°（P = .02）。术后平均常数评分从39分提高到62分（P = 0.01）。静息疼痛的VAS从术前的3.3改善到0.1（P = .02）。 ADL的增值服务从4.9改善到2.3（P = .05）。转移的背阔肌在所有情况下均保持活跃，这反映在绑架任务期间背阔肌肌电图活动增加。此外，背阔肌肌电图的活性从术前的拮抗共激活转变为绑架的协同激活。结论：背阔肌转移后具有协同增肌活性。除肌腱作用外，定向肌肉活动似乎与改善临床结果和缓解疼痛有关。在升高的手臂位置观察到了外部旋转的特定增益，这是ADL任务必不可少的动作。

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